Lap Band RNY Duodenal Switch Adjustable Yes No No Requires re-arranging the intestines No Yes Yes Protein-calorie malnutrition No 48 per cent at one year Over 50 per cent at one year Requirement for protein powder No Sometimes if needs cannot be met with food Sometimes if needs cannot be met with food Malabsorption of protein No Yes Yes Malabsorption of iron No Yes Yes Weight loss at three years Over 60 percent of excess body weight Over 60 percent of excess body weight Over 60 percent of excess body weight Requirement for calcium supplementation None Yes Yes Yearly labs Only those routine labs your PCP recommends Extensive list An even more extensive list B12 injections No Often Rare Reversibility Easiest of all Extensive surgery Very extensive surgery Post op hernias Rare Common with open 22 per cent Bowel obstruction or internal hernias Very rare 2-4 per cent 2-4 per cent Pregnancy Deflate band if needed Wait at least two years post op and monitor carefully Wait at least two years post op and monitor carefully Danger of malnutrition with pregnancy None Folate deficiency can cause spina bifida Folate deficiency can cause spina bifida

Post op Recovery Lap Band RNY Duodenal Switch Operative time Usually less than an hour 90 minutes and up Two hours and up Hospitalization Often same day surgery Two to four days after surgery Two to four days after surgery Pain management Tylenol Narcotics Narcotics Return to normal activity or work Less than a week Two to six weeks Two to six weeks Post op Death Rate 1 in 10,000 1 in 200 1 in 200 Leak causing peritonitis No Yes Yes High-risk operation No Yes Yes High death rate No Yes Yes Irreversible No Yes Yes Dumping No Yes Sometimes Vitamin Deficiencies No Yes Yes Stricture No Yes Yes Internal hernia No Yes Yes Diarrhea No Yes Yes Increased kidney stones No Yes Yes Erratic absorption of medications No Yes Yes Unhealthy muscle wasting No Yes Yes Excess Flatus No Yes Yes

There are many important distinctions between the procedures. If you look at the common complications of weight loss surgery, the Lap Band is much safer. Many complications related to the gastric bypass do not exist with the Lap Band. Gastric bypass complications are common, severe and can result in death or long-term disability. Band complications are rare, minor and easily fixed as an outpatient in most cases.

When surgeons become patients, when they have bariatric surgery on themselves, most of them choose gastric banding over the bypass or DS. More than anyone, surgeons have an intimate knowledge of the risks associated with the various operations. Many hospital nurses working in the operating room or surgery ward will choose to have a band over a bypass or DS. After witnessing firsthand gastric bypass and DS patients die or have serious complications they tend to steer away from those procedures and choose a band instead. This ought to tell you something about the differences in the risks between the procedures.
When band patients reach their healthy weight, they are healthy. When bypass or DS patients reach their goal weight, they still have a chronic disease called malabsorption. These malabsorptive procedures leave patients appearing sallow, with muscle wasting, and requiring complex regimens of vitamins, calcium, iron, and sometimes distasteful protein powders.